How Does Smoking Affect Healing and Scarring After having Plastic Surgery? Tri Valley Plastic Surgery

I'm a smoker. They (any facial surgeon) say you MUST quit smoking 2-6 weeks before and I'm having a real problem with that. I went from 20 to 24 cigs. a day down to 2 and still its a problem. Perhaps someone could elaborate on the why and how it effects the healing process, scaring etc. Thank you.

Smoking and Surgery

For wound healing there are actually two factors. First - Nicotine causes blood vessel constriction, reducing blood supply to the skin. When we perform surgery the incisions we leave reduce normal blood flow. We count on the remaining blood supply that we haven't cut to keep skin and soft tissue alive. Smoking works directly against this. Second - Smoking also causes small vessel damage (which takes longer to reverse) which compromises blood flow. In addition to wound healing issues, smoking also makes anesthesia more complicated. Smoke actually paralyzes your cilia (little hair like structures in your lungs that help move debris out of the smallest parts of your lungs). This is why when you wake in the morning you have a cough that is quieted by a nice cigarette. Overnight you haven't smoked and some of those cilia have recovered and have been moving junk out of your lungs and you cough it out. That AM cigarette stops the cilia motion again and you don't need to cough because the debris stays in the lungs. This as well as many other problems with smoking can significantly increase anesthesia complications which can lead to prolonged intubation, pneuomonia, etc. All of these reasons are why most plastic surgeons will ask people to stop smoking prior to surgery. I hope this helps!